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April 4, 2022: Christine Parent, Associate Vice President at MEDITECH joins Bill for the news. How has the Chief Medical Information Officer role changed? We look at CMIO 3.0 where they have moved from initial EHR implementation to EHR optimization, strategic input on AI, population health efforts and patient engagement. 97% of Americans own a cellphone but it’s shocking to know that, until recently, mobile adoption in health care has lagged. How can we accelerate the move from clunky, outdated software to a more mobile environment? And will Google become the future of Electronic Health Records? Find out as they announce their partnership with MEDITECH.

Key Points:

What is the conference booth strategy? Is it a marketing play or a sales play?

Population health efforts are massively challenging with the data sets that you have to acquire

The whole idea of board certified CMIOs is going to be the trend






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Today on This Week Health.

We've gone in and looked at the new smart hospitals that we're seeing are being built today. It's a very exciting time. And I do think I'm hopeful that as the acceleration of the mobile devices and these digital platforms continue to evolve and accelerate that that also accelerates maybe that next iteration of what this could be for healthcare.

It's Newsday. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, 📍 a channel dedicated to keeping health IT staff current and engaged. Special thanks to CrowdStrike, Proofpoint, Clearsense, MEDITECH, Cedars-Sinai Accelerator, Talkdesk and DrFirst who are our Newsday show sponsors for investing in our mission to develop the next generation of health 📍 leaders.

All right. It's news day. And today we are joined by Christine Parent with MEDITECH. And Christine. Welcome. Welcome back to the show.

Thank you, bill. It's nice to be here again.

Well it was nice to to actually connect in person? We actually saw each other at the HIMSS event. I don't remember seeing you at the vibe event, but I did 30 interviews. So my mind a little.

Oh, meditech was both at the HIMSS event. And we had a booth there as well as where we've always been a chime member for a number of years. But this was the first time they had a Vive conference, which has the health conference combined with the chime. And so we also had a footprint there in the. At the vibes. So really it was as one person put it to two conferences back to back. So I think by the end of the HIMS conference, people were ready to get home.

Yeah. I'm thinking of coming up with a new conference and doing like three back to back to back, seeing how that goes. No, I I'll tell you if people were people who went to both were. The people who had booths and whatnot, they were tired at the end of the day. That was a, that was a lot of work. I do want to talk to you a little bit about, about the conferences. I here's the thing I liked about ViVE, they had a standard side booth size booth, right?

So they didn't have the super booths where you could walk in and I don't know, had multiple floors and living areas and you name it. And I felt like that sort of leveled the playing field a little bit. I liked that. I did like the speed dating with vendors talking about the match,

the match, the match team, or they pull this, something to that respect where you get to sign up and get 20 minutes with someone to talk through. They liked that by the way, the feedback of some of the organizations that I know that set through, that thought that that was a good. Way to meet a lot of people. And I thought that that was well done, that they did, and kind of infused in a different type of energy.

Yeah. I heard a lot of positive things on, on the, on the hymns event. Hymns look like hymns, right? So I had phenomenal events ahead of time. They had the CNIs. The nursing informatics group got together and I spent some time in there. They're doing some great work and it was just. I mean, and they feed off each other. I mean, they share stuff and they feed off each other.

That was fantastic. There was a leadership forum. The CIO forum, I think morphed into the leadership forum because they had just had a chime. So probably could not get a quorum of just CEO's. But a lot of leaders in that room, there was a a security event. So those day before events are. Phenomenal for networking and learning and those kinds of things. And then I think we were, I don't know about you. I will say I was surprised people have told me up to 28,000 and they said, do you think there was 28,000? There I'm like, well, if it wasn't 28, it was 25. It was close. I was not like, it was not like they were fibbing by 10,000.

It was, it was pretty close to whatever that number was. it was well attended and I was the surprise for me. But outside of that, it was pretty much a HIMS conference and what we expect from a HIMSS conference.

Yes. And, to your point, it was nice getting everyone back in person to either of the conferences. And I did think that they did a nice job. They did, I believe condense a little bit of their footprint at him. So it wasn't so spread out amongst the conference areas. And I do think that that lend itself to feel like it was. Fuller conference, but also it was, everything was very easy to get to all in one area.

But to your point though, when you mentioned about Vive and, coming from a company that has booths. You spend a year designing a HIMSS booth and you, you work with different companies to put the footprint together. Having something like a Vive where I call it a pop-up booth.

Where you have three styles in which to select from you, provide them with all the graphics. They go ahead and wrap it. So your folks that are actually showing up that the day before, everything's pretty much set up for you. You're not sending people out three or four days before to build it and then take it down different environment.

I do think. I liked the concept of smaller areas. I thought it was much more easily accessible for people to get around, but I do, I have to say that that hymns people didn't know was it going to be well attended? I do think their attendance definitely increased when I was with you. I was very surprised to see so many. So many friends that I hadn't seen in about two or three years with everything going on. So

because you have a marketing background as part of your role. And I talked to one, one booth participant who said no, all in, they were at about $400,000 for the, for the hymns booth. I'm not sure by the way, if people are like, oh my gosh, can't believe hymns is charging that much. I'm not sure the Vive booths were. If I started rattling off the rates, I think people nuts, but the but at the end of the day all in people traveling and you name it about 400,000 and so that was one strategy.

I talked to another startup that everybody would know because they get a lot of press and they got a lot of press during the two conferences. And I said, you know what, what's your all in costs? They're like, well, we we, we had four people fly in essentially a marketing person to COO a CEO and somebody else. And I'm like, how did you get so much place? Like, well we had lined up interviews, we had lined up all this other stuff and they got a lot of play. Now, I guess my question to you is what's the strategy or do you look at it more like. are these events marketing plays or are they sales plays?

I think this is where we get lost because people are like, oh, the CIO is weren't at the, the hymns event. Therefore we weren't talking to him and as many buyers and I I'm trying to figure out what the, what the mindset is going in.

Well, I think it's probably different depending on what your, what your product or service is. And I know for us anyways, we don't consider it just a marketing or sales thing. We, we actually combine the two because we want to, we have current customers that we want to show the latest and greatest. We have new prospects that we want to be able to provide an environment for them to, come to our booth, to see what we have, who we are.

We want to make sure that leadership is available for them to schedule meetings with. So for us having a booth or a location makes sense for some of the ones that are up and coming. I know that a lot of them, especially at vibe they had the smaller smaller footprints that were kind of more on the outskirts.

And you, you walked up and you kind of heard about what their organization. I know a couple of our partners that had just meeting rooms at hymns. And, but that that goes to a smaller space how do you get your, your word out? Obviously you're probably not doing a lot of software presentations or service discussions. So it probably depends on what your product is. And for us, I don't think we'll ever get rid of the booth concept, but do we structure that a little differently? More many pop-up boosts in different areas, depending on what the subject is.

Yeah. We could go into this for a while and I may hit you up later for some of these things. Like when you get the map, are you thinking, oh, I got to be near a door. I need to be near I'm sure there's a whole logic to it, but I want to get to some of the stories that you picked out here. let's start with CMIO 3.0, how the chief medical information officer role has evolved.

And this story has, is really looking at the life of three CMIOs CT, Lynn MD at UC health. In the Rockies area, you have Natalie Padgeler PDG E L E R Fleur. Yup. Stanford children's health. And then you have let's see, see William Hanson, the third MD CMIO Penn medicine in Philadelphia. And they use that as a backdrop to have this conversation around how the CMIO role has changed. And I know back in the day, so back in 2011, we did have a major EHR consolidation. And really the CMIO was pretty much the the lead on that. That was the sort of the role that EHR implementation coming out of that they became the head of optimization, which never ends. But they became the head of optimization. And now the role is, is really evolving as more tools and new technologies come into play. what struck you about this?

First of all. I agree with you. I think that when we started to see this in our customer base, it was probably the early 2010s. So you were, we were right on the cusp of leading that charge bill, because these were in some cases, relatively new titles that were being introduced. And a lot of it was I think, the push for meaningful use and trying to do these upgrades to big EHR systems. So they put in the CMIO to act as that facilitator with the physicians to make sure that they were moving them along. And I'm with You I think optimization for the next decade, got a bad, a bad word associated with it. And a lot of that fell to the CMIOs. I love the concept. And what struck me with this. Is how the role has evolved in how the CMIO really has made it to more of a strategic player. The concept of not necessarily actually having that dotted line or reporting up to the CIO, but really more on the CEO, driving the strategy. Being involved in more things that are maybe not just always in what we'd consider the traditional wheelhouse. And I think this pandemic also created a visibility to that role that in many cases, I know the CMIO. And CML we're out there talking to the community about vaccinations. In some cases they were at the board level talking about

they've, they've, really become leaders. I mean, it's, you, touched on a couple of things here and it's, it's in the article. So let's see CT lens says like many other CMIOs. He gradually took on more and more responsibility until they gave him the CMIO title. And he said, I actually had to grow into the title as well. He, he said, initially I was just managing myself and that's the CMI was sort of that standalone person. He goes, now I have 25 people. Right. And so it does become a.

That's one of the aspects of it. They now manage somewhat manage a budget. So they have to go in front of the board, have conversations during the pandemic. They went in front of the board. I'm sure. Pretty often in terms of capabilities, But also, they talk about a new set of tools that are, starting to emerge where they're becoming strategic.

As you mentioned, AI population, health efforts, patient engagement efforts. They tend to be right there at the center of those conversations. and this is one of the few times where somebody has given it a 3.0 title where. Really see 1.0 2.0 and 3.0. And 3.0 is how are you going to lead transparency around your AI models and your algorithms and work with the clinicians to make sure you're adopting the right tools.

Population health efforts are. Massively challenging with the data sets that you have to acquire, understand how to aggregate them look at the social determinants data and bring that in into the clinical workflow and partnerships into that workflow. And then patient engagement is something. I think that you'll find this interesting.

I think it lives in between operations, technology and marketing. This is the one area we don't talk about, but patient engagement. Probably need more health system marketing people at the table.

Absolutely. We're seeing that bill by the way. So we are seeing where some of these patient engagement programs are actually being led from a leadership perspective by the marketing chief marketing officer. And in many cases we are seeing that some of the larger institutions, really morphine and changing that role. I'm seeing more CMOs showing up at some of these healthcare conferences than ever before. in speaking on panels and talking about the secret sauce in which they did to engage, because I do think that there's, there's something to that, but just, just to add one thing, because you talked about someone that is morphing early early in 1.0 or 2.0 iteration.

Had he was a physician or she was a physician first had an interest in some sort of either implementation or it, and all of a sudden got this new title. So what we're seeing, when we talk about AI, you talked poppy about population health, which you have to add interoperability to all of that, these new digital platforms.

He talked about patient engagement, so you're talking apps, app development, again, digital health platform. Now there's programs to send these positions to, to learn those it components and certifications. And I do believe you were at you were at the Vive conference and chime in chime is also starting their own set of different courses in different certifications and graduate programs, really to help move along. Some of the, even the physician leadership, which I think is, is interesting. And that was also something that came through in the article.

Yeah, it did sort of towards the end here. one thing that is relatively new for CMIOs is board certification in informatics that will soon require having completed a fellowship. We are now in our seventh year of clinical informatics fellows. Our program is growing like gangbusters, Stanford. Children's. Page letter says our graduates are ending up all over the world and really incredible leadership positions. We interesting to see if this will eventually become the only path to becoming a CMIO.

So that's interesting. Penn medicine's Hansen said he is increasingly working with younger clinicians who have substantial experience either from a research perspective or. They are experienced data scientists just from their work in college and whatnot. So that is really fascinating to see.

And I think we're going to see more colleges and universities step up and more programs be developed, especially at the academic medical centers. this, this whole idea of board certified CMIOs across the board probably is going to be probably going to be the trend. So people are probably going to start lining up for those certifications and for good reason, it's a very complex world that we live in.

📍 📍 We'll get to our show in just a minute. As you've probably heard, we've launched a new show TownHall on our Community channel. This Week Health community. And it airs on Tuesdays and Thursdays. I'll be taking a back seat to some of these people who are on the front lines. TownHall is hosted by an array of talented healthcare leaders who are facing today's challenges head-on. We're going to hear from professionals and their networks on hot button issues, technical deep dives, and the tactical challenges that healthcare faces. We have some great hosts on this. We have Charles Boicey and Angelique Russell, Data Scientist, Craig richard v ille, Lee Milligan, Reid, Stephan, who are all CIOs. We have Jake Lancaster and Brett Oliver who are CMIOs and Matt Sickles, a Cybersecurity first responder. I'd love to have you listen to these episodes. You can subscribe on our Community channel. This Week Health Community, wherever you find and listen to podcasts. Now let's get to the show. 📍 📍

All right. I'm going to give you, I talked to Helen Waters from Meditech about their Google announcement about your Google announcement, but I want to go to Mayo Scougal announcement. We'll come back to a. Meditech's in a minute. Mayo clinic assessing Google AI tool. As it seeks more insights from patient records, the health care provider says Google's healthcare NLP, natural language API could help clinicians determine whether certain patients are at a higher risk for disease.

And this is the kind of thing that people are tapping into Google for. So Mayo clinic said is X assessing the, a product from Google cloud that uses AI to better track analyze language based information in the patient's EHR or the technology known as NLP has made it stride in recent years at says experts, although it remains and it's early days he goes on to say some 80% of the patient data in electronic medical records is unstructured.

That's still amazing. But I guess that's the case, including transcribed reports and doctor's notes doctor and and then said NLP allows the hospital system to turn that data that isn't organized into discrete fields, into structured data. Any clinicians will have an easier time searching and analyzing it.

So this, this becomes about. Unlocking that data for starters, but this is where it really dovetails into the Meditech announcement. It becomes about the clinicians being able to find an access that data very quickly because they're seeing. 1213 patients this hour and they can't be digging through this, this file cabinet of stuff and reading PDFs and whatever the, the unstructured data is, they gotta be able to search it. And that's, so they're using NLP to make discrete data elements and maybe do some other things. MEDITECH you guys, you guys are using their search capabilities, right?

We are, we're using their search and summarization. So as you mentioned they have their own product that they're going to be going to market and they've made their announcement.

We've taken some of those components from that care studio product, which is some of the tools and actually embedded it within our toolbox in our EHR. And it's the search and summarization, but to your point, It is trying to actually create a holistic view of the patient. And it's looking at different areas, whether different care areas or to your point different documents that may not be discrete data.

An example I'll give you is for legacy systems, as you've done upgrades or whatnot, there's some scanned documents out there. So being able to actually get in process and go through scanned document. An individual like bill Russell, Dr. Bill Russell, who has a patient in front of him is not going to have, probably go through a scanned document for data, but there might be data in there that would allow you to treat the patient better.

So having a search in summarization that goes through just it's very similar, I think, to what you explained here, going through and doing the NPL and those documents, you're able to actually get that information and bring it back discretely and actually put it as part of the summarization and that. That is something that they do well. And to be honest, you, we we're, we obviously put out a press release and you you've talked about it. But the physician and the patient really don't care who does that search and summarization, they just want to be treated well. And the physician should never know that it's quote unquote, a Google tool that provided that data for them. It should be.

every time this comes up, we have to talk about privacy because I saw somebody. Who made a very cogent argument on patient data and patient privacy, whatnot. And they use the Google Meditech announcement. And underneath I said, you used the wrong story. This is, this has absolutely nothing to do with that.

There's no patient data that's moving. No one's making money from this aspect of it. I'm like, if you want. And I gave him like, here's, here's, here's three stories you should look at. If you're worried about patient data, being used to make money for somebody without the patient's consent, but that's not what this is about. This is just about the benefit to me is the clinician benefits, just productivity and ability to really spend more time with patient I'd benefit as patient, because they're going to. Information at their fingertips. And hopefully by having that information at their fingertips, they don't have to ask me the same battery of questions. Every time I come in, or at least not as long a battery of questions and the information they need will be there so that they can provide better care and maybe pay, pay a little bit more attention to me rather than the computer.

Perfect. And that's, that's really what we're going for. And I agree with you on the privacy. We are we're working with them when the development of this in that is the first and foremost, the top of what is on Meditech's mind to make sure that we do everything right. That we cross our T's dot our I's and the data is still the institution, the healthcare systems data. It's still the patient's data. It's not, it's not owned by anyone else that it's not shared with anyone else. But it, it does to your point, create a longitudinal record that I think. Is, is what we're all aiming for. And to your point, just to make sure that you're getting back to that patient provider relationship without a lot of document searching in between.

Absolutely. We're going to close on this story. Why the future of healthcare is mobile. And I love the sentence. It starts with five years ago, healthcare providers didn't see mobile as a priority or as a necessary tool in improving the patient experience. And that it just ends with this. The pandemic changed that.

Yeah, it did. It did change that really everything went mobile. I mean now granted, some people are at home on their desktops, but meaning everything changed during those, the two and a half years that we've gone through this pandemic of how clinicians want to view the data, where they want to view the data, how they want to share the data and a lot of that has changed our thinking on architecture, where now I hear CEOs all the time talking about cloud architecture and I'm like, thank God we've been talking about this since 2010, but now they're all saying, Hey, we can't do it without it. And I'm like, yeah, that's, that is absolutely true. The world, the world changed over the last two years. What's what struck you about this?

So, so this is one of the first ones that that really struck me because from a Meditech standpoint, anyways, I will agree with you that the rest of the industry has. Just perked up in during the pandemic and kind of absorbed and move forward and leaned forward in this direction.

But I will tell you I think that I probably mentioned before that our new expanse platform was built 10 years ago and was all based on web mobile, knowing that this was the direction that we believed the industry in technology. And so not necessarily to built on. Completely recreate and redesign a post meaningful use with the technology that was available.

And I will tell you when we first started to deploy it and try to put smartphones and tablets and the nurses and physicians hands we didn't have some challenges where people wanted to go back to maybe more of a hybrid model. And so I, I think that we've worked through those challenges and the one that are the higher satisfying areas or organizations have really embraced the mobile strategy. Now fast forward eight plus years, you're going through the pandemic. We've talked about digital technology. We talked about the rise of patient experience. And you're, you're now looking at it and this is a must have, this is an a we need this right now.

the mobility creates and improves communication. It expands what your digital platform is to be able to expose yourself to some of these apps for consumer engagement. So I will say this one, at least struck a chord for me because we knew we would get. I think there was just some segments of the industry that was just slower to adopt and see the importance of moving to this.

I'll tell you from a CIOs perspective, one of the biggest challenges was, Hey CIO, we need a thousand more tablets or some more phones. It's like okay, we'll get that in the budget somehow. But I'll tell you, I'll tell you that. The other thing is the. I, I tell this story from time to time. I don't think I tell it all that often.

Although my father is here and he tells the same stories over and over again. So I might fall into this category. And I had a guy on my staff, Mustapha, cures, ATA, and he came to me and said, build a future is mobile. And this was back in like 2013. I'm like, oh, okay. What do you want me to do about it? He goes, just give me a little bit of money and let me, let me run with this idea. And his idea was that we wouldn't have PCs in any of the, rooms. And he took a an Android device and had a a Citrix client on it. And he showed that he could run Metatech our standard Meditech on it at the time.

Now with expanse, this would have been so much easier. but essentially, and they could go from room to room and just drop it into this, this holder. And it would, it would then go up onto the screen and there would be a keyboard there and they'd have a full-blown session Citrix session. So they were really running off. workstation in the cloud and they could do this and then they could go to the next room, pop it in, do the next one and that kind of stuff. And even that's probably by today's standards. Well, actually by today's standards, it would still be warp speed compared to what we were still putting machines in every one of the rooms.

And I think there's, there's a case to be made that if you fast forward 10 years from now, The standard PC box will not be in the room. There will be some sort of a voice recognition box when you walk and the TV will be somehow linked so that you can just put whatever you want up on that screen, you can pull up Something from your phone, you can watch TV, you can do all sorts of things. And I, I used to say that thing and say, well, that's the future? That's buck Rogers kind of stuff. But I don't, I mean, all those things, I just sort of rattled off. We could do today. If somebody sorta take takes the time and really thinks through the future patient room, I think it'll look really different.

It will definitely be mobile. and, and that's not even taking into account that our nurses are now being dispatched to homes. And so it'll definitely be mobile. I the Meditech vision of people are going to be taking the EHR with them to people's homes was pretty forward-thinking at the time. And I think it's going to serve you well, especially as, as we start to move into the.

Yeah. And then you just mentioned the next iteration of the ambient listening which we talked about kind of going more the frictionless, like, is there going to be a device? What would the device potentially look like? That's all being looked at right now. There's some technology that's out there that I know that we've, we've gone in and looked at the new smart hospitals that we're seeing are being built today in time. No drop lines in the rooms that so it's very, it's a very exciting time. And I do think I'm hopeful that as, as the acceleration of the mobile devices and these digital platforms continue to evolve and accelerate that that also accelerates maybe that next iteration of, of what this could be for healthcare.

Fantastic. Christine, as always great to catch up with you. Thanks for coming on the show.

Perfect. Thank you, bill.

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